Although alkylating agents are active, combination chemotherapy is superior to single agent therapy in patients with advanced ovarian cancer. Doxorubicin and cis-platinum is an active combination. VP16-213 has activity in male germinal tumors. The combination of cis-platinum, doxorubicin, cyclophosphamide and VP16-213 creates the possibility of multiple synergistic pairs. This four-drug combination is therefore studied for the treatment of advanced epithelial tumors of the ovary. Two patients have been entered into study. There is suggestion of antitumor activity with partial responses in both patients who had advanced high grade tumors. It is too early to evaluate for response or toxicity. Salvage chemotherapy in patients with ovarian carcinoma, endometrial carcinoma, or cervical carcinoma rarely exceeds 10% to 20% response rates. In the current study 22 patients with advanced gynecologic malignancies (8 ovary, 9 cervix, 2 endometrial, and 3 adenosquamous) have been treated with 120 mg/m2 of mAMSA. Two partial responses, one in endometrial carcinoma and one in cervical carcinoma, have been observed in 20 evaluable patients. It is still too early to evaluate level of activity since at least 15 patients per tumor type are needed to exclude a 20% possibility of activity.